Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2023 Mar 22:16:697-704.
doi: 10.2147/CCID.S391709. eCollection 2023.

IncobotulinumtoxinA for the Treatment of Glabella and Forehead Dynamic Lines: A Real-Life Longitudinal Case Series

Ana Lucia Gonzaga da Cunha  1 , Rossana Vasconcelos  2 , David Di Sessa  3 , Gabriel Sampaio  4 , Pitila Ramalhoto  5 , Bruno F Zampieri  6 , Bárbara S Deus  7 , Suyan Vasconcelos  8 , Talitha Bellote  9 , Juiano Carvalho  10 , Giseli Petrone  5 , Vinicius Figueredo  11 , Gustavo Limongi Moreira  3
Affiliations
Case Reports

IncobotulinumtoxinA for the Treatment of Glabella and Forehead Dynamic Lines: A Real-Life Longitudinal Case Series

Ana Lucia Gonzaga da Cunha et al. Clin Cosmet Investig Dermatol. .

Abstract

Background: There is substantial interpersonal variation in the patterns of muscular contraction that substantiates the use of personalized points of application and dosages in clinical practice to achieve optimal results. Nevertheless, there has been no real-life therapeutic series with botulinum toxin for aesthetic treatment of the face in which the subjects were systematically followed to assess its long-term benefit.

Purpose: To assess the performance and length of the treatment of glabellar and forehead lines with IncobotulinumtoxinA in a real-life setting.

Patients and methods: We enrolled 20 adults with indications for the treatment of upper facial dynamic lines (glabella and forehead) with botulinum toxin. The protocols of injection points were personalized by the injectors. The participants were photographed under maximum facial contraction before the application (D0) and after 15, 90, 120, and 180 days. The photos were randomly assessed by two blinded experienced raters to consensually grade the dynamic lines according to the Merz Aesthetics Scales (MAS). Efficacy was defined as the reduction in the MAS score.

Results: At D15, 18 (90%; 95% CI: 80%-100%) participants reached the zero score, or a 2-point reduction on the MAS score from the forehead and 16 (80%; 95% CI: 65-90%) reached that reduction for the glabella. These values from D90 were 14 (70%; 95% CI: 55-85%) for both sites. At D120, these values were 11 (55%; 95% CI: 35-75%) and 8 (40%; 95% CI: 25-55%) for the forehead and glabella. At D180, 10 (50%; 95% CI: 30-70%) participants presented a MAS score for forehead or glabella dynamic lines lower than the score assessed at D0.

Conclusion: As much as 70% of the patients sustained a reduction of scores after 120 days of the treatment for dynamic glabellar and forehead lines. Half of the patients evidenced prolonged benefit at 180 days.

Keywords: ONE21; Xeomin; botulinum toxin; dynamic wrinkles; incobotulinumtoxinA; injection technique; upper face.

PubMed Disclaimer

Conflict of interest statement

Ana da Cunha is an employed of Merz. Rossana de Vasconcelos, David di Sessa, Gabriel Sampaio, Pitila Ramalhoto, Bruno Zampieri, Bárbara Deus, Suyan Vasconcellos, Talitha Bellote, Juliano de Carvalho, Giseli Petrone, Gustavo Moreira Vinícius Figueredo are medical speakers of Merz Aesthetic. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Sequential visits (previous to 180 days) from a participant who received 23 units of IncobotulinumtoxinA on the glabella. Photos under maximum contraction.
Figure 2
Figure 2
Sequential visits (previous to 180 days) from a participant who received 22 units of IncobotulinumtoxinA on the forehead. Photos under maximum contraction.
Figure 3
Figure 3
Sequential visits (previous to 180 days) from a participant who received 44 units of IncobotulinumtoxinA on the forehead. Photos under maximum contraction.
Figure 4
Figure 4
MAS scores of dynamic lines of the forehead at D0, D15, D90, D120, and D180 (n = 20).
Figure 5
Figure 5
MAS scores of dynamic lines of the glabella at D0, D15, D90, D120, and D180 (n = 20).
Figure 6
Figure 6
Percent (95% CI) of participants with any improvement in forehead MAS dynamic lines severity, according to the visits (n = 20).
Figure 7
Figure 7
Percent (95% CI) of participants with any improvement in glabellar MAS dynamic lines severity, according to the visits (n = 20).
See this image and copyright information in PMC

References

    1. Zargaran D, Zoller F, Zargaran A, Weyrich T, Mosahebi A. Facial skin ageing: key concepts and overview of processes. Int J Cosmet Sci. 2022;44:414–420. doi:10.1111/ics.12779 - DOI - PMC - PubMed
    1. Griffiths TW. Facial ageing: how do we measure up? Br J Dermatol. 2015;172:1182. doi:10.1111/bjd.13785 - DOI - PubMed
    1. Rexbye H, Petersen I, Johansens M, Klitkou L, Jeune B, Christensen K. Influence of environmental factors on facial ageing. Age Ageing. 2006;35:110–115. doi:10.1093/ageing/afj031 - DOI - PubMed
    1. Prager W, Nogueira Teixeira D, Leventhal PS. IncobotulinumtoxinA for aesthetic indications: a systematic review of prospective comparative trials. Dermatol Surg. 2017;43:959–966. doi:10.1097/DSS.0000000000001076 - DOI - PubMed
    1. Camargo CP, Xia J, Costa CS, et al. Botulinum toxin type A for facial wrinkles. Cochrane Database Syst Rev. 2021;7:CD011301. doi:10.1002/14651858.CD011301.pub2 - DOI - PMC - PubMed

Publication types